Abstract

People with type 1 diabetes (T1D) have difficulty controlling glucose during exercise. Different types, intensities, and durations of exercise impact glucose differently. There is currently no algorithm that can accurately predict glucose changes during aerobic, resistance, interval, and free-living exercise. A support vector regression (SVR) model was designed to predict the maximum change in glucose during exercise. The model was trained and validated on 30-minute exercise sessions collected twice weekly over 4 weeks from 33 people with T1D (age 33±13 years, BMI 26.3±2.9 kg/m2, 18±12 years since diagnosis). Participants completed study assigned aerobic (n = 40), resistance (n= 33), or interval (n=20) exercise sessions in addition to their typical exercise regimen (n = 254). Participants wore a Dexcom (G5 or G6) or Medtronic CGM and used their own insulin pen (n = 10) or pump to administer insulin. The exercise information and food consumed was reported using a custom app. Heart rate, accelerometry, and sleep metrics were acquired using a Garmin vivosmart watch. Training was done on 90% of the observations while 10% of data were used for testing using 10-fold cross validation. The mean absolute error (MAE) of the model-predicted change in glucose during exercise was 23.59 mg/dL. The SVR algorithm may be useful within a decision support tool to help people with T1D better manage their glucose levels during exercise. Disclosure G. Young: None. Z. Li: None. P. Calhoun: Stock/Shareholder; Self; Dexcom, Inc. R.L. Gal: None. R. Beck: None. J.R. Castle: Advisory Panel; Self; Novo Nordisk Inc. Consultant; Self; ADOCIA, Dexcom, Inc., Zealand Pharma A/S. Other Relationship; Self; Pacific Diabetes Technologies, Roche Diabetes Care. M.A. Clements: Consultant; Self; Glooko, Inc. Other Relationship; Self; Glooko, Inc. E. Dassau: Consultant; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; Roche Diabetes Care. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. F.J. Doyle: Research Support; Self; DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Stock/Shareholder; Self; Mode AGC. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. M.B. Gillingham: None. C.K. Martin: Advisory Panel; Self; EHE Health, NaturallySlim. Consultant; Self; Florida Hospital, Gila Therapeutics, OpenFit, Zafgen, Inc. Research Support; Self; Egg Board, Helmsley Trust, IDEA Public Schools, National Institutes of Health, NIHR, Patient-Centered Outcomes Research Institute, USDA, Weight Watchers International, Inc. Other Relationship; Self; Academy of Nutrition and Dietetics, Louisiana State Univ./Pennington Biomedical Research Center. M.R. Rickels: Consultant; Self; Semma Therapeutics, Inc. Research Support; Self; Xeris Pharmaceuticals, Inc. S.R. Patton: None. M. Riddell: Advisory Panel; Self; Zucara Therapeutics Inc. Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc., Insulet Corporation. Speaker’s Bureau; Self; Medtronic, Novo Nordisk A/S. P.G. Jacobs: Consultant; Self; SFC Fluidics. Research Support; Self; Dexcom, Inc. Stock/Shareholder; Self; Pacific Diabetes Technologies. Other Relationship; Self; AgaMatrix. Funding Exercise in Diabetes Initiative (T1-DEXI Main Study)

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